infectionsduringpregnancy-baterial infectins.pptx

community health

1. LEPROSY (HENSEN DISEASE) IN PREGNANCY

2. mycobacterium leprae With established leprosy, there is chance of exacerbation of the lesions during pregnancy. However, the baby should be separated from the infected mother, immediately after delivery. When the disease becomes quiescent and non-infectious, the baby may be given to the mother. Dapsone and Clofazimine appear safe in pregnancy..

3. GONORRHOEA

4. GONORRHOEA Organism : Neisseria gonorrhoeae Transmission : Gonorrhea is transmitted by close sexual contact. The incubation period is 3 to 5 days.

5. Signs and symptoms Vaginal discharge: may be profuse purulent and yellow green Itching or swelling of vulva Dysuria Dyspareunia Joint and tendon pain Anal discharge, discomfort and pain with rectal infection.

6. Screening Molecular diagnostics . Endocervical culture

7. Treatment in Pregnancy cefixime , 400 mg orally, or one dose of Ceftriaxone , 125 mg intramuscularly. Sexual partners within the preceding 60 days should be identified, examined, cultured and treated.

8. Effect on pregnancy outcome It can affect pregnancy outcome in any trimester, causing chorioamnionitis , pre term delivery, PROM, IUGR or postpartum sepsis. If the organism is present at the time of delivery, the greatest neonatal risk is gonococcal ophthalmia , which can cause blindness.

9. SYPHILIS

10. SYPHILIS Syphilis is a sexually transmitted disease caused by Treponema pallidum .

11. Signs and symptoms Incubation- 10 to 90 days Primary syphilis Stage one is evident by a chancre, which is highly infectious, painless, round ulcerated sore that does not get better fast. It may last 3 to 6 weeks.

12. Secondary syphilis: evident by a maculopapular rash This rash usually exhibited between 1 week and 3 months after primary chancre. It typically clears in 2-6 weeks but can last upto one year. Other manifestations include wart like genital growth, lymphadenopathy , fever, sore throat, patchy hair loss, head ache weight loss, muscle aches and tiredness.

13. Latent syphilis: Stage three is usually asymptomatic. The spirochete goes to hiding for 5 to 20 years. The patient is seroactive during this stage. During the first year of this stage, the patient is infectious.

14. Tertiary syphilis: The fourth stage is remanifestation of the disease. It slowly destroys the heart eyes, brain, CNS, and occasionally the liver, bones and skin.

15. Investigations : Serological test- VDRL fluorescent treponemal antibody absorption test (FTA- ABS) Treponema pallidum micro – haemagglutination (MHA- TP) test which are specific.

16. Treatment For Mother : For primary and secondary syphilis(<I year duration): Benzathine penicillin 2.4 million units intramuscularly single dose. When the duration is more than 1 year- Benzathine penicillin 2.4 million units intramuscularly weekly for 3 doses is given.

17. For Baby : Positive serological reaction with a single intramuscular dose of penicillin G 50,000 units per kg body weight. Infected baby with positive serological reaction- (1) isolation with mother (2) IM administration of aqueous procaine penicillin G 50,000 units per kg body weight each day for 10 days.

18. URINARY TRACT INFECTIONS

19. URINARY TRACT INFECTIONS Asymptomatic bacteriuria Cystitis Pyelonephritis

20. Organism: E.coli , klebsiella pneumonia, proteus species in recurrent UTI. Less frequent gram positive causative organism includes group B streptococci, enterococci and staphylococci.

21. Transmission: sexual intercourse and improper wiping after defecation.

22. Signs and symptoms Urinary frequency Urinary urgency Dysuria Hesitancy and dribbling Suprapubic tenderness Gross hematuria Accompanying symptoms with pyelonephritis usually are chills, fever, and backpain with costovertebral angle tenderness.

23. Screening Microscopic examination shows WBC, bacteria may or may not be present. Dip urine may be positive for nitrates and leukocyte esterase Clean catch midstream specimen for culture and sensitivity.

24. Treatment in pregnancy for asymptomatic bacteriuria and acute cystitis: antibiotic therapy for asymptomatic bacteruria is effective in lowering the risk of pyelonephritis and preterm labour . Usually 7-10 day course is preferred

25. Treatment in pregnancy for pyelonephritis : The usual treatment is amoxicillin clavulanate ( augmentin ) 875 mg bd for 7-10 days Cephalosporin

26. Effect on pregnancy outcome The endotoxins released from gram negative bacteria may stimulate the production of prostaglandins and thus cause preterm labour .

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